Planning a Search Strategy PICO, Concept Boxes and Boolean Operators

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  • Planning a Search StrategyPICO, Concept Boxes and Boolean Operators

  • Online Searching at a Glance

    Useful terminology:Pearl Searching: find a good article aka pearl and look at the referencesBoolean operators: most databases allow boolean operators to narrow or broaden a search (AND, OR, NOT)Truncation: most databases use symbols such as * for truncation, e.g., dent* will retrieve dental, dentistry, dentist, etc.


  • ANDbisphosphonates AND osteonecrosis

  • ORosteonecrosis OR death of bone OR bone death OR bone necrosis

  • osteonecrosis NOT femur head necrosisNOT

  • Truncation

    Using * (asterisk) and ? (question mark)

  • Using * to truncate retrieves any ending after the truncated part of the word.

    Manag* will retrieve manage, management, manager, etc.

  • But, be careful

    Truncating too soon can be problematic

  • cat*catcats

  • ? will find different spellings within a word

    wom?n will retrieve woman and women

  • ? can also be used to find British/Canadian and American spelling

  • gr?y cat

  • gr?y cat grey cat gray cat

  • British and North American spellings vary. When entering textwords in search engines for international databases such as Cochrane or Medline, it is necessary to allow for the different spellings, or else some citations may be missed.Use$or:to get all possible endings (e.g. computer, computers, computing, computed, etc.)Use#to replace exactly one character ( for woman or women)Use?to replace 0 or 1 character (labo? for labor or labour)

    ExamplesU.S.BritishIn OVID, enter as:anemia/anaemiaetiology/aetiology

    gynecology/gynaecologyhemoglobin/haemoglobin-e--ae-an?emia"etiology or aetiology"gyn?ecology"hemoglobin or haemoglobin"esophagus/oesophagusfetus/foetusdiarrhea/diarrhoea-e--oe-"esophagus or oesophagus""fetus or foetus"diarrh?eatumor/tumour -o- -ou-tumo?rorganize/organise-z--s-organi#ecounseling/counsellingcounseled/counselled-l--ll-counse$ling for specific endingcounselsulfur/sulphur -f- -ph-sul#?urfiber/fibre -er- -re-fib:

  • Steps to finding articlesIdentify the main concepts or keywords

    Determine the best resources

    Plan the search

    Document the search and cite

    Evaluate what you find

  • Example topicYour hospital wants to implement a policy of placing all HIV+ patients on INH prophylaxis therapy. You have been asked to do a review to see if that is successful in preventing tuberculosis, in particular in other African countries.

  • Identify the main conceptsThe easiest way to make your question searchable is to break it up into concepts

    For each concept, think of as many keywords/synonyms as you can

    A very popular method to use is PICO

  • Identify the main conceptsPICO Method

    P Population I InterventionC Comparison (Optional)O Outcome

  • PICO Example Continued P HIV positive in African countries I INH prophylaxis therapyC n/aO decreased rates of tuberculosisAnswerable Question: In African countries does INH prophylaxis therapy help reduce the rates of tuberculosis among HIV positive patients?

  • Think of synonyms or similar terms or ideas to use in your search

    PICOPICO conceptsPossible search termsPatient PopulationHIV positive patients in African countriesHIV positive, HIV infection, human immunodeficiency virus, Africa, Ethiopia, Eastern AfricaIntervention INH prophylaxis therapyINH prophylaxis therapy, INH preventive therapy, Isoniazid, IPTComparison (if any) n/an/aOutcomeReduction of cases of tuberculosis Tuberculosis

  • Determine the best resources There are hundreds of article databases available. Which one will you use?Most popular databases are:MEDLINE (accessible either through PubMed or Ovid)Cochrane LibraryEMBASEWeb of ScienceScopus Google Scholar????

  • Plan the searchNow you have your searchable questions and keywords. Where do you start?

    Each database has its own indexing system. Many have their own thesaurus or list of subject headings. If the database you are using has a thesaurus, match your keywords to the thesaurus for a more efficient search.

  • Using a databaseOnce youve chosen a database, such as Medline or PubMed, search for each concept separately

    Use OR to combine synonyms or similar terms or concepts (HIV+ OR HIV positive)

    Use AND to combine separate concepts (HIV positive AND tuberculosis AND INH prophylaxis therapy)

  • Save your searches by creating an account in each database that you use

    Use a citation management tool such as Zotero, Medeley or Endnote Web to export your citations from multiple databasesDocument the search and cite

  • Please always evaluate the information you find, either by using given criteria or developing your ownEvaluate what you find


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